Would you like to be able to provide culturally appropriate mental health services to your Latino clients?
A few days ago, I had the pleasure of attending Dr. Parra-Cardona’s workshop at the Ackerman Institute for the Family on providing an ecological and culturally relevant framework for working with the Latino population in clinical practice.
According to Dr. Parra Cardona, there are the following 3 key models (or frameworks) to keep in mind while working with Latinos:
1. Ecological Theory
2. Transgenerational Cultural Identity Formation
3. Cultural Identity
Ecological Theory (Parra-Cardona, 2013)
Within the Ecological Theory, examples of macrosystem factors to consider (Parra-Cardona, Córdova, Holtrop, Villarruel & Wieling, 2008) are:
Among [some] Foreign Born Latinos:
Macrosystem Risk Factors: stigma, intense health and mental health disparities, intense discrimination and work exploitation, anti-immigration climate.
Macrosystem Protective Factors/Pulls: economy and safety, community, cultural values and spirituality.
Among [some] U.S. Born Latinos:
Macrosystem Risk Factors: stigma, health and mental health disparities, legacies of discrimination, segregation, cultural identity cut-off (forbidden to speak mother tongue).
Macrosystem Protective Factors: citizenship (rights and benefits), access to welfare system and potential biculturalism.
Transgenerational Cultural Identity Formation:
- Experiences of connection, differentiation, dynamics of oppression, and resiliency have a major impact on the process of immigration and cultural identity formation.
- Hence, Dr. Cardona recommends discussing with an individual (or family) what impact their arrival in the United States has had vis a vis these elements.
- Similarly, it is important to explore what it is currently like for the individual/family currently in terms of these elements of connection, differentiation, oppression and resiliency.
- In other words, this model looks at the pushes vs. the pulls.
- Pushes refer to the elements that that pushed the individual (or family) away from the country of origin [typically accompanied by feelings of loss].
- Pulls refer to the elements that enable the person/family to survive or thrive here.
- Some examples of pulls:
- Connection [it is important for new immigrants to establish meaningful connections with both new country’s minority and majority]
- Differentiation [i.e., what do they like/dislike about old/new country, prior social class/new social class]
- Resilience [i.e. personal qualities and use of social support networks]
The Cultural Identity framework (Parra-Cardona, Wampler & Busby, 2004) has the following 4 dimensions:
- Country of origin orientation: individuals do not want to identify with many elements of host country
- U.S. oriented: individuals consider themselves citizens of the host country and do not want many (if any) elements of country of origin
- Bicultural: individuals whose identity is based upon an integration of both cultures; they’ve incorporated elements of both cultures.
- Cultural identity search which involves three possibilities: [typically, victims of trauma are at this point b/c they are in survival mode]
- Country of origin open to expand
- U.S. oriented open to expand or
- Moratorium [not thinking about this]
In other words, the objective would be to ask your Latino client various questions so as to get a feeling on what their experiences were like in the various areas addressed in the above-mentioned models.
In so doing, you would not only be validating their historical and current stories, but you would also be demonstrating a desire to understand where they are coming from.
This, in turn, according to Dr. Parra-Cardona, is likely to yield for you both increased engagement and better clinical outcomes with your Latino clients.
For more information on the use of these models, I urge you to read one or more of the many articles he has written on the subject (note that evidence of the effectiveness of these models has been demonstrated in a number of his studies). Alternatively, you could consider attending one of his future workshops on this topic.